The comparison of aprotinin compared to lysine analogues in cardiac surgical patients:meta - analysis
LIAO Guoping
DENG Fangwen
SUN Degui
HU Jianhua
LIN Jingming
YIN Xinsheng
Abstract：Objective:To compare the effect of aprotinin with lysine analogues on cardiac surgical patients. Methods:To perform a meta - analysis of randomised controlled trials and observational studies with the following data sources August 2015, and reference lists of identified articles. Results:Thirty - one studies included 33 501 patients. Early mortality was significantly increased after aprotinin vs lysine analogues[RR = 1. 86,95% CI(1. 53 ~ 2. 25),P < 0. 000 01]in the low and the intermedi-ate risk subgroup[RR = 1. 40,95%(1. 18 ~ 1. 66),P = 0. 000 1],respectively. Contrarily,the mortality did not significantly differ between aprotinin and lysine analogues in the high risk subgroup[RR = 1. 03,95%(0. 67 ~ 1. 58),P = 0. 90]. Mean-while,the aprotinin could decrease the risk of transfusion and bleeding complications[RR = 0. 79,95% CI(0. 70 ~ 0. 89),P <0. 01]. Conclusion:Aprotinin may be associated with an increased risk of mortality in low and intermediate risk cardiac surger-y,but presumably may has no effect on early mortality in a subgroup of high risk cardiac surgery compared to lysine analogues. Thus,decisions to relicense aprotinin in lower risk patients should critically be debated. In contrast,aprotinin might probably be beneficial in high risk cardiac surgery as it reduces risk of transfusion and bleeding complications.
Keywords：aprotininlysine analoguescardiac surgerymeta - analysis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 723-730 )